Intercalary frozen autograft for reconstruction of malignant bone and soft tissue tumours

Int Orthop. 2017 Jul;41(7):1481-1487. doi: 10.1007/s00264-017-3446-x. Epub 2017 Mar 25.

Abstract

Purpose: In 1999, we developed a technique using frozen autografts-tumour-containing bone treated with liquid nitrogen-for the reconstruction of malignant bone tumours. The purpose of this study was to evaluate the functional and oncological outcomes of frozen autografts for intercalary reconstruction of malignant bones and soft tissue tumours.

Methods: This retrospective study was designed to assess 34 patients of mean age 35 (range, 6-79) years. The mean follow-up period was 62 (24-214) months. The median length of the frozen autografts was 138.4 ± 60.39 (50-290) mm.

Results: Postsurgically, 20 patients remained disease-free, seven patients survived with no evidence of disease, five patients were alive with disease, and two patients died of disease. The five- and ten-year survival rates of the frozen autografts were 91.2% and the mean International Society of Limb Salvage score was 90%. Complete bony union was achieved in 97% of the patients. There were five cases of nonunion, six cases of fracture, two cases of deep infection and four cases of local recurrence.

Conclusion: Utilizing intercalary frozen autografts for patients with a nonosteolytic primary or secondary bone tumour without involvement of the subchondral bone is a good alternative treatment, because it is a straightforward biological technique and can provide excellent limb function.

Keywords: Frozen autograft; Intercalary reconstruction; Malignant bone tumours.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Autografts
  • Bone Neoplasms / mortality
  • Bone Neoplasms / surgery*
  • Bone Transplantation / adverse effects
  • Bone Transplantation / methods*
  • Bone and Bones / pathology
  • Child
  • Female
  • Follow-Up Studies
  • Freezing
  • Humans
  • Limb Salvage / methods
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Retrospective Studies
  • Soft Tissue Neoplasms / mortality
  • Soft Tissue Neoplasms / surgery*
  • Survival Analysis
  • Survival Rate
  • Transplantation, Autologous / adverse effects
  • Transplantation, Autologous / methods*
  • Young Adult